The Usefulness of Selective Nerve Root Block as a Predictor of Prognosis of Lumbar Disc Herniation.
10.4184/jkss.2005.12.3.192
- Author:
Dong Ho LEE
1
;
Min Seok KIM
;
Kang Sup YOON
;
Seung Baik KANG
;
Hyuh Chul JO
;
Kun Woo PARK
;
Kwang Sup SONG
;
Jin Sup YEOM
;
Bong Soon CHANG
;
Choon Ki LEE
;
Ji Ho LEE
Author Information
1. Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea. jiholee@brm.co.kr
- Publication Type:Original Article
- Keywords:
Lumbar spine;
Disc herniation;
Selective nerve root block
- MeSH:
Follow-Up Studies;
Humans;
Leg;
Prognosis*;
Prospective Studies;
Radiculopathy;
Visual Analog Scale
- From:Journal of Korean Society of Spine Surgery
2005;12(3):192-199
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: A prospective study. OBJECTIVES: To investigate the usefulness of selective nerve root block (SNRB) as a prognosis predictor of a lumbar disc herniation. SUMMARY OF LITERATURE REVIEW: The biochemical factors of radiculopathy, as opposed to the biomechanical factors, are more reversible and responsive to a corticosteroid injection. MATERIALS AND METHODS: Fifty patients underwent SNRB for the radiculopathy caused by a herniated lumbar disc and were followed for at least 1 year. The straight leg raising (SLR) angle, visual analog scale (VAS) and the patients' subjective satisfaction, using the Weber criteria, were initially investigated, and again at 1 week and 1 month after the procedure, and finally at the final follow-up. The patients were divided into two groups according to the final satisfaction. Group 1 (satisfactory prognosis, N=32) had Excellent/Good results at the final follow-up, whereas Group 2(unsatisfactory prognosis, N=18) had Fair/Poor final results, or underwent surgical treatment. The improvements in the SLR and VAS at 1 week and 1 month were compared between two groups. The subjective satisfaction each time was compared to the final outcome; the relative risks were also calculated. RESULTS: The improvements in the SLR and VAS for Group 1 were significantly better than those for Group 2 at both 1 week and 1 month (p<0.05). Those patients with Excellent/Good results at 1 week and 1 month manifested satisfactory final outcomes (p<0.05). The risks of the patients with Fair/Poor results at 1 week and 1 month manifesting unsatisfactory final outcomes were 6.8 and 15.2 times higher than those with Excellent/Good results. CONCLUSION: Selective nerve root block could be a useful method, not only to relieve acute leg pain, but also to predict the longterm prognosis of a herniated lumbar disc. Early surgical treatment could be considered for the patients not manifesting significant improvement until 1 month after SNRB.
